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ESA 4 - HaDSoc > Sociological Approaches to Chronic Illness > Flashcards

Sociological Approaches to Chronic Illness Flashcards

1
Q

What does the term chronic illness emcompass?

A

A wide range of conditions

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2
Q

What are the features of chronic illnesses?

A
  • Long term
  • Has a profound influence on the life of suffererse
  • Often have co-morbid conditions
  • Manifestations vary greatly day-to-day
  • Can be controlled, but not cured
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3
Q

What is the problem with manifestations of chronic illnesses varying greatly day-to-day?

A

Leads to a lot of uncertainty, and issues managing life and social interactions

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4
Q

Why is the incidence of chornic illnesses increasing?

A

Due to the aging population

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5
Q

What % of GP appointments to people with long term conditions account for?

A

50%

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6
Q

What % of all outpatient appointments do people with long term conditions account for?

A

64%

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7
Q

What % of all inpatient bed days to people with long term conditions account for?

A

70%

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8
Q

What % of the total health care spend in England do people with long term conditions account for?

A

Around 70%

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9
Q

What is a detailed understanding of the impact of chronic illness and disability on daily life necessary for?

A

For providers of medical and social services to offer appropriate care and support

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10
Q

Why is a sociological approach to chronic illness distinct?

A
  • Focuses on how chronic illness impacts on social interaction and role performance
  • Modern theory is mostly derived from studies in the interactionalist tradition
  • Concerned with experiences and meanings of chronic illness
    • Interested in how people manage and negotiate chronic illness in everyday life
      *
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11
Q

What do illness narratives refer to?

A

Story telling and accounting practices that occur in the face of illness

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12
Q

What happens in an illness narrative?

A

A patient can ‘tell the story’ of their illness

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13
Q

What is the advantage of narrative interviews?

A

Can see what the patient places significance on, and what is important to them

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14
Q

What is much of the sociological research on chronic illness based on?

A

Peoples narratives of their illness

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15
Q

What do illness narratives offer?

A

Information about how the patient makes sense of something, and thus an insight into lay beliefs, and how they perform certain functions

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16
Q

What types of work does the sociological theory of chronic illness say there is?

A
  • Illness work
  • Everyday life work
  • Emotional work
  • Identity work
  • Biographical work
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17
Q

What does illness work constitute?

A
  • Work getting a diagnosis
  • Managing the symptoms
  • Self-management
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18
Q

What aspects of getting a diagnosis can be problematic?

A
  • May be prolonged period of uncertainty
  • Problems arise from ambivalent status of some diagnoses
  • Process can be very unpleasant
  • Diagnosis itself
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19
Q

When may there be a prolonged period of uncertainty when getting a diagnosis?

A

If conditions are complex or unusual, or not the normal candidate

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20
Q

When may the process of getting a diagnosis be very unpleasant?

A

Patient may have to be very proactive

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21
Q

What may a diagnosis be?

A
  • Profoundly shocking
  • Very threatening
  • A relief
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22
Q

Why may a diagnosis be a relief?

A

Finally have a diagnostic label so can do something about it

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23
Q

What is central to the coping with chronic illness task?

A

Dealing with the physical manifestations of illness

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24
Q

What has management of symptoms need to be done before?

A

Coping with social relationships

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25
Q

How does the body in chronic illness interact with identity?

A
  • Uncontrollable problematic behaviour can impact on who you can be, and what you can do
  • Bodily changes can lea to self-perception changes
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26
Q

What is the problem with optimum-self management?

A

It is difficult to achieve

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27
Q

What can sub-optimum self management lead to?

A
  • Poor rates of adherence to treatment
  • Reduced quality of life
  • Poor psychological wellbeing
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28
Q

How can self-management be improved?

A

Can provide brief interventions

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29
Q

How can interventions to improve self management be delivered?

A
  • Online
  • In person
  • Via telephone
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30
Q

How to interventions to improve self management vary?

A

In effectiveness/quality

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31
Q

Give an example of an intervention aimed to improve self-management?

A

The ‘expert patient programme’

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32
Q

What does the ‘expert patient programme’ do?

A

Teaches coping and condition management skills, and aims to reduce hospital admissions

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33
Q

What is the expert patient programme facilitated by?

A

Patients

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34
Q

What are the disadvantages of the expert patient programme?

A
  • Responsibility for care is placed on very ill patients, who sometimes have to do significant, complex work
  • Little evidence of efficiency savings
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35
Q

What is doing in everyday life work?

A
  • Coping and strategic management
  • Normalisation
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36
Q

What is coping?

A

The cognitive processes involved in dealing with illness

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37
Q

What does strategy refer to?

A

The action and processes involved in managing the condition and its impact

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38
Q

Give two examples of strategy in chronic illness

A
  • Decisions about mobilisation of resources
  • Decisions about how to balance demands on others and remain independant
39
Q

What are the methods of normalisation in chronic illness?

A
  • Some try and keep pre-illness lifestyle and identity intact
  • Some redesignate new life as ‘normal life’
40
Q

How does a person keep pre-illness lifestyle and identity intact?

A

Disguise or minimise symptoms

41
Q

How does a person redesignate their illness life as ‘normal life’?

A

May involve people signalling changes in identity, rather than preserving old ones

42
Q

Over what time scale does redesignation of new life as ‘normal life’ take place?

A

Can occur over a very short period of time if a rapid onset illness

43
Q

What does emotional work refer to?

A

The work that people do to protect the emotional well-being of others

44
Q

What happens in emotional work?

A

Maintaining normal activities becomes deliberately conscious

45
Q

Why don’t people let others see that they’re feeling unwell?

A

Don’t want to upset people around them

46
Q

Who may the hiding of symptoms of a chronic illness extend to?

A

HCP

47
Q

What is important considering that some people with chronic illness will hide their symptoms from HCPs?

A

HCPs must have the skills to break this down

48
Q

What may happen regarding friendships in chronic illness?

A

May find friendships disrupted, and may strategically withdraw or restrict their social terrain

49
Q

What may emotional work involve?

A

Downplaying pain or other symptoms, to present ‘cheery self’

50
Q

What does the devastating impact on role in chronic illness refer to?

A

How people position themselves in a social sphere

51
Q

How may role change in chronic illness?

A

Dependency, and feeling of uselessness to self and others

52
Q

Who may the role change in chronic illness be especially devastating for?

A

Young people

53
Q

Why is biographical work needed in chronic illness?

A

Because there is a loss of self as a former self-image crumbles away without simultaneous development of equally valued new ones

54
Q

What is the constant struggle in chronic illness, regarding biographical work?

A

To lead valued lives and maintain positive definitions of self

55
Q

What is it argued regarding the focus on physical discomfort in chronic illness?

A

It minimises the broader significance of suffering for people with chronic illness

56
Q

Why is chronic illness a major disruptive experience?

A
  • Threatens sense of taken-for-granted world
  • New consciousness of the body, and fragility of life
  • May experience grief for former life
  • Biographical sift from a perceived normal trajectory to an abnormal one
57
Q

Why is identity work needed in chronic illness?

A

Different conditions carry different connotations and certain cultural stereotypes, which affects how people see themselves and how others see them

58
Q

What is the risk with chronic illness regarding identity?

A

Illness can become the defining aspect of identity

59
Q

What is stigma?

A

A negatively defined condition, attribute, trait, or behaviour conferring ‘deviant’ status

60
Q

What may result in stigma?

A

Control of the body means that we present ourselves in socially valued ways, and failure to do this may result in stigma

61
Q

What types of stigma are there?

A
  • Discreditable
  • Discrediting
62
Q

What is discreditable stigma?

A

When nothing is seen, but if it was found out, may be treated differently

63
Q

Give two examples of conditions that may produce discreditable stigma?

A
  • Mental illness
  • HIV +ve
64
Q

What is the difficulty with discredibable stigma?

A

Have to decide who to tell, how, when, and what are the implications?

65
Q

What is discrediting stigma?

A

When there is a physically visible characteristic, or something that is well known

66
Q

Give two examples of conditions giving discrediting stigma?

A
  • Physical disability
    • Known suicide attempt
      *
67
Q

What are the ways of experiencing stigma?

A

Can be felt, or enacted

68
Q

What is enacted stigma?

A

The real experience of prejudice, discrimination, and disadvantage as a consequence of a condition

69
Q

What is felt stigma?

A

The fear of enacted stigma

70
Q

What does felt stigma also encompass?

A

The feeling of shame associated with having a condition

71
Q

What does felt stigma lead to?

A

Selective concealment

72
Q

What has evidence shown that most chronic disorders are in their effects?

A

Disabling

73
Q

Describe the relationship between chronic illness and disability?

A

Complex and disrupted issue

74
Q

What does the medial model say about disability?

A

Disability is deviation from medical norms, and disadvantages are a direct consequence of impairment and disabilities which needs medical intervention to cure or help

75
Q

What are the critiques of the medical model of chronic illness?

A
  • Lack of recognition of social and psychological factors
  • Stereotyping and stigmatising language
76
Q

What are doctors trying to do, regarding the medical model?

A

Move away from thinking in a purely medical model

77
Q

What does the social model say about chronic illness?

A

Problems are a product of the environment, and a failure of the environment to adjust

78
Q

What is meant by disability being a product of the environment?

A

Disability is a function of a society which fails to take into account people with impairments, and special needs are only in a particular context

79
Q

What is disability a form of, according to the social model?

A

Social oppression

80
Q

What does the social model say is needed to combat chronic conditions?

A

Political action and social change

81
Q

What are the critiques of the social model of chronic conditions?

A
  • Body is left out
  • Overly drawn view of society
  • Failure to recgonise bodily realities and extent to which these are solvable socially
82
Q

What did the International Classification of Impairments, Disabilities, or Handicaps (ICIDH) do?

A

Attempted to classify consequences of dieases

83
Q

What concepts did the ICIDH offer?

A
  • Impairment
  • Disability
  • Handicap
84
Q

What is impairment concerned with?

A

Abnormalities in the structure or functioning of the body

85
Q

What is disability concerned with?

A

The performance of activity

86
Q

What is handicap concerned with?

A

Broader social and psychological consequences of living with impairment or disability

87
Q

Is there a relationship between the severity of impairment and of resulting disability or handicap?

A

Not necessarily

88
Q

What are the criticisms of the ICIDH?

A
  • Problematic use of term ‘handicap’
  • Implies problems are intrinsic or inevitable
  • Embodied many features of medical model
89
Q

What is the International Classification of Functions, Disability, and Health (ICFDH)?

A

WHO’s framework for measuring health and disability at borth individual and population levels

90
Q

When was the ICFDH officially endorsed by all WHO member states?

A

In the 54th World Health Assembly in 22nd May 2001

91
Q

What is the ICFDH endorsed for?

A

Use as the international standard to describe and measure health and disability

92
Q

What does the ICFDH attempt to do?

A

Integrate medical and social models, and recognise the significance of wider environment

93
Q

What are the key components of ICFDH?

A
  • Body structures and functions, and impairments of/to
  • Activities undertaken by the individual, and difficulties/limitations experienced in doing them
  • Participation or involvement in life situations, which may become restriction
94
Q

What are all the components, and relationships between them, affected by in the ICFDH?

A

Personal and environmental contextual factors

ESA 4 - HaDSoc (13 decks)

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